I had a sleep test done and the doctor got very angry

[MarkMyWords]

A bit about my self , I am 65 years old American retired expat permanently living with my wife in Cambodia , and a few months ago after going to bed I started to wake up in the early hours of the morning with a sensation that I could not breath in enough air . These sensations did not happen every night and there were no other symptoms . The symptoms only happened for a few seconds each time. I have no symptoms in the day time other than a stress / anxiety problem that I have had for some time and which I am now trying to address.

So after checking out my symptom on the internet , it seemed the best solution was to have a sleep test done . So I booked a sleep test at a local government hospital and once it was complete I left the hospital the next morning. I had to wait three weeks for the sleep test report and then went back to the hospital where the doctor went over the sleep test reports findings , it was a shock to be told that I was suffering from severe sleep apnoea. The doctor said that my score was 33 and that I should go and purchase a CPAP unit and use it at home.

In the three weeks I had to wait for the sleep test report the symptoms I had been experiencing had gone and now I’m staying asleep every night without any of the past symptoms. When I told the doctor that over the three week waiting period for the report findings I had not been experiencing any of my past symptoms . The doctor on hearing what I had just said started to get defensive and obviously angry ( here doctors are some times considered un approachable and are not normally challenged or questioned by the local population ) .


I asked the doctor why did they think my symptoms had now gone, the doctor replied in a strong agitated tone that may be I don’t need a CPAP unit after all and it was ‘’ up to me ‘’ if I wanted to get a CPAP unit.


The doctor then said that in the next room there was a sales representative of a private company that sells CPAP units and I should go and now talk to them. So still a bit unsure I went to see the CPAP unit sales person and they went straight into their sales pitch . So I sat there alone and listened until the sales person finally confirmed the cost . One comment that the sales person ( in English ) made was . I sell a lot of CPAP units and masks to people who come to see the sleep doctor because every one who had sleep test done their results indicated they need to buy a CPAP unit and mask ( surprise surprise ).

I said thank you to the sales person and said that I will think about the information that they had gone over . As I was walking out of the room the sales person said that if I purchased the CPAP unit and mask directly from them and not through the hospital or mention it to the hospital , I would be offered a good discount on the CPAP unit and mask price.


The government hospital were I had the sleep test done is the only local one that can offer a sleep test option, there’s another hospital but that's too far away from where I live , so undergoing a second sleep test seems to be a difficult and expensive further option . Another thing that crossed my mind was the hospital room where I stayed for the sleep test was very noisy ( outside road noise and the rooms old air condition machine noise through out the night ) so I found it hard to sleep and a bit annoying.






After going through all of the above I’m now feeling unhappy and disenchanted , the whole experience is making me think a few things like , can I trust the sleep test results taking into consideration what seems to be a strong CPAP unit sales association between the doctor / hospital and the sales representative and if I add the comment made by the sales representative that the private CPAP sales company gets to sell a lot of CPAP units to people who come to see the sleep doctor .




I’m still confused and undecided by the whole experience , and have a few questions that I hope some one here would be kind enough to answer for me.


Is it considered normal to have a CPAP unit sales person from a private company within a hospital and the doctors recommend seeing them and purchasing from them.

Can some tell me is it possible to have a first sleep test and the results show severe sleep apnoea and then a few weeks later have another sleep test and the new results show no or low sleep apnoea .

Could the sleep test results be wrong in some way .

Arranging a second sleep test is going to be difficult as I don’t want to go back to the same hospital where I had the original sleep test done . Is there any way some how I could try to confirm my situation relating to sleep apnea my self.

Just searching on the interment it seems that general consensus is that if your sleep report says that you have sleep apnoea , then you have it and that's it. Would you agree on that statement ?

I have read the written ( in English ) sleep test report and its a bit confusing so I’m wondering if I can find some way of getting it checked out or at least have some one to take a look at it .

[jnk...]

Doctors sometimes get angry when social norms are violated in the way their opinions seem to them to be challenged. This often happens when they are asked a question that they don't know the answer to.

Nevertheless, it is likely that you would benefit greatly from optimized PAP pressures.

Get a good APAP, one that reports full efficacy data to you, from a reputable source, and then manage your own therapy from there.

[Miss Emerita]

It would help people give you advice if you could post your complete report. Be sure to redact personal information before you post it. If you don’t have a copy, get one!

[JayDee]

... because every one who had sleep test done their results indicated they need to buy a CPAP unit and mask ( surprise surprise )...

No too terribly surprising if you think about it. If you go see a cardiologist, you probably have a cardiac issue. If you go see a podiatrist, you likely have a podiatry issue. Hence, the people who go see a sleep doctor and have a sleep test done... Well, there's no guarantee they have sleep apnea, but they probably didn't go there because everything's fine...

I'm no Vegas odds setter, but I would wager that most folks middle age or older are good candidates for developing some flavor of sleep apnea.

I don't know if you have OSA or not but if so, do yourself a favor and get a machine & mask. With the help of the good folks here, you can quite likely manage your therapy as good as, if not better than, your sleep doc and that's no exaggeration.

Good luck!
-JD

[Janknitz]

Your story is a variation on a theme we see all the time here. Are you familiar with the 5 stages of grief from Elizabeth Kubler Ross? Denial, Anger, Bargaining, Depression, Acceptance. I'd say you are in the denial stage, but also experiencing some anger and bargaining.

As pointed out, if you have sleep apnea symptoms and you have a sleep apnea test, it's very likely that you are going to turn out to have sleep apnea, not a bladder infection. I'm going to assume that they have good medical standards there, and the test was not a sham.

Sleep apnea does not "go away" on it's own. And the fact that you had an AHI of 32 when you didn't sleep well during the test doesn't bolster your argument--your sleep apnea may be WORSE when you get into deep REM sleep (IF you even can). We don't know what goes on while we sleep, so the fact that you don't perceive symptoms means nothing about whether you have sleep apnea or not. It may have been your lucky day when you had enough symptoms to seek testing, but you may not recognize that yet.

So bottom line is that UNLESS you have another test saying you don't really have sleep apnea, you must assume that you do. And you must treat it, if you want to age gracefully and in good health and mobility. No bargaining is going to change that.

One of the great frustrations about sleep apnea is that we have ZERO control over what our breathing does in our sleep, other than to use CPAP to keep the airway open. I find that lack of control the most frustrating part.

So take control where you can. You DO have control over the selection of mask and machine. Maybe the doctor IS getting a kickback, maybe the machine this guy wants to sell you for a bargain price isn't a bargain. Or maybe neither is true. Do your research. Find out what machines and masks you can obtain where you live, how much they cost from various sources, and what's the best deal for you. Find out how they work and how to optimize this therapy for yourself. Take control of your health instead of getting stuck in anger and denial--that won't benefit you. Empower yourself to take charge.

[MarkMyWords]

Doctors sometimes get angry when social norms are violated in the way their opinions seem to them to be challenged. This often happens when they are asked a question that they don't know the answer to.

Nevertheless, it is likely that you would benefit greatly from optimized PAP pressures.

Get a good APAP, one that reports full efficacy data to you, from a reputable source, and then manage your own therapy from there.

.

[MarkMyWords]

It would help people give you advice if you could post your complete report. Be sure to redact personal information before you post it. If you don’t have a copy, get one!

Thanks , I'm going to now post my sleep test results .

[MarkMyWords]

... because every one who had sleep test done their results indicated they need to buy a CPAP unit and mask ( surprise surprise )...

No too terribly surprising if you think about it. If you go see a cardiologist, you probably have a cardiac issue. If you go see a podiatrist, you likely have a podiatry issue. Hence, the people who go see a sleep doctor and have a sleep test done... Well, there's no guarantee they have sleep apnea, but they probably didn't go there because everything's fine...

I'm no Vegas odds setter, but I would wager that most folks middle age or older are good candidates for developing some flavor of sleep apnea.

I don't know if you have OSA or not but if so, do yourself a favor and get a machine & mask. With the help of the good folks here, you can quite likely manage your therapy as good as, if not better than, your sleep doc and that's no exaggeration.

Good luck!
-JD

Thanks for your thoughts, they are appreciated .

I’m very happy to have found this forum and look forward to learning a lot more about OSA.

[MarkMyWords]

Your story is a variation on a theme we see all the time here. Are you familiar with the 5 stages of grief from Elizabeth Kubler Ross? Denial, Anger, Bargaining, Depression, Acceptance. I'd say you are in the denial stage, but also experiencing some anger and bargaining.

As pointed out, if you have sleep apnea symptoms and you have a sleep apnea test, it's very likely that you are going to turn out to have sleep apnea, not a bladder infection. I'm going to assume that they have good medical standards there, and the test was not a sham.

Sleep apnea does not "go away" on it's own. And the fact that you had an AHI of 32 when you didn't sleep well during the test doesn't bolster your argument--your sleep apnea may be WORSE when you get into deep REM sleep (IF you even can). We don't know what goes on while we sleep, so the fact that you don't perceive symptoms means nothing about whether you have sleep apnea or not. It may have been your lucky day when you had enough symptoms to seek testing, but you may not recognize that yet.

So bottom line is that UNLESS you have another test saying you don't really have sleep apnea, you must assume that you do. And you must treat it, if you want to age gracefully and in good health and mobility. No bargaining is going to change that.

One of the great frustrations about sleep apnea is that we have ZERO control over what our breathing does in our sleep, other than to use CPAP to keep the airway open. I find that lack of control the most frustrating part.

So take control where you can. You DO have control over the selection of mask and machine. Maybe the doctor IS getting a kickback, maybe the machine this guy wants to sell you for a bargain price isn't a bargain. Or maybe neither is true. Do your research. Find out what machines and masks you can obtain where you live, how much they cost from various sources, and what's the best deal for you. Find out how they work and how to optimize this therapy for yourself. Take control of your health instead of getting stuck in anger and denial--that won't benefit you. Empower yourself to take charge.

Thanks for your input , I had to look up the 5 stages of grief from Elizabeth Kubler Ross.

Like you say - if you have sleep apnea symptoms and you have a sleep apnea test, it's very likely that you are going to turn out to have sleep apnea – makes sense .

I’m just starting down the road and trying to learn all I can about OSA and I hope with the help of yourself and other kind members here to eventually learn a lot more and come to terms with and understand my situation.

One area I’m having trouble in understanding is how my original symptoms can after three weeks just go away , hopefully I will learn to understand that point along the way.

I have managed to find a reliable source for a ResMed AirSense 10 – Autoset unit and Phillips DreamWear Nasal Mask . Obtaining a second sleep test is going to be problematic .

Thanks for your advice , its appreciated.

[MarkMyWords]

Here are my sleep test results ,( sorry about the quality ) I have my fingers firmly crossed that some one would be kind enough to have a look and comment on the reports findings.

First 3 pages

[MarkMyWords]

Next 3 pages

[MarkMyWords]

Last page ( Note No snoring at all . )

[Julie]

It occurred to me to ask about the (even very slim) possibility that you had a passing respiratory problem when tested (that prompted the testing) and it just went away... things do after all. Can you think back to pre-testing and come up with anything at all that might fit and that could have skewed test results but otherwise then disappeared?

[Cpapian]

Not all people are aware of sleep apnea symptoms ..... the fact that you no longer experience the symptoms does not, in of itself, mean the apneas are gone. Apnea events can occur more frequently under certain conditions. Events like REM sleep, a tucked chin, sleep position contribute to the frequency, timing and number of events you will experience. You might recognize those events that awake you fully, but will be oblivious to the ones that only caused a partial arousal.

When you get your data capable machine and download OSCAR you will see the ebb and flow of your nights events. Some nights events may come in a cluster and other nights events will be widely spaced apart.

[cyberdreamer]

Regarding how to interpret your exam, the most important statistics are Apnea Index (AI), Hypopnea Index (HI), Apnea-Hypopnea Index (AHI) (a sum of the previous 2 numbers) and Oxygen desaturation time (time below oxygen saturation of 90%).

From what I understand from the tests, your oxygen levels dropped below 90% for about a minute and you had an AHI of 35.0 (HI = 15.6 and AI = 19.4). Your AHI number is classified as severe apnea. It can be interpreted as meaning that on average you wake up 35 times every hour of sleep because you're choking!

Since you had a high AHI when sleeping on your left side, it's also unlikely that you are candidate for positional therapy alone, but I'm not sure 25 minutes of sleep on that side is enough to make this conclusion.

My personal symptoms of untreated apnea were: headaches every morning, waking up during the night with full bladder multiple times and feeling as I'm more tired than before going to bed. Do you have any of these?

If you can afford the machine, I suggest getting an APAP as others have mentioned. I'm not aware of clinics faking sleep studies to sell CPAP machines and as someone already mentioned most people who go to the sleep doctor have some issue, so it's not surprising that most sleep studies are positive.

http://healthysleep.med.harvard.edu/sle ... ng-results